Living with
Post-traumatic Stress Disorder (PTSD)
Understanding Post-traumatic Stress Disorder (PTSD)
What is post-traumatic stress disorder?
Most of us have experienced some kind of traumatic event in our lifetime. Usually with time, the emotion related to the event decreases. However, there are a number of individuals who fail to escape the experience of a traumatic event and remain anxious and severely distressed for extended periods of time. These people might have what is known as post-traumatic stress disorder (PTSD).
PTSD is a serious and often debilitating condition that can occur in persons who have experienced, witnessed or heard of a traumatic event involving themselves or a significant other.
How might you be able to recognise PTSD?
PTSD occurs in those who have experienced traumatic events that can involve:
- Human violence (e.g. rape, physical assault, domestic violence, kidnapping, or violence associated with military combat)
- Natural disasters (e.g. floods, earthquakes, tornadoes or hurricanes)
- Accidents involving injury or death
- A sudden, unexpected death of a family member or friend
- Diagnosis of a life-threatening illness.
The core symptoms of PTSD are:
- Re-experiencing the traumatic event through intrusive memories or recurrent dreams of the traumatic event, and experiences feelings and behaviours as intensely as if they were recurring (flashbacks; nightmares).
- Avoidant symptoms include an emotional numbness towards others and events, and ways in which the person tries to avoid anything associated to the traumatic event.
- Hyperarousal symptoms, including difficulty falling or staying asleep, irritability or outbursts of anger, difficulty concentrating, hyper-vigilance (being on the watch for danger), and an exaggerated startle response.
How is PTSD diagnosed?
PTSD is usually diagnosed by a mental health professional (a psychologist or psychiatrist), if the above mentioned symptoms persist a month or longer after the traumatic event has occurred.
It is common that before seeking help, someone suffering from PTSD would have experienced a multitude of symptoms that would ultimately lead to a formal diagnosis. Often, however, symptoms do not present until several months or years after the trauma. This is known as delayed onset PTSD. In cases where symptoms have lasted 3 months or more, the PTSD is termed “chronic”.
If you have experienced a traumatic event, contact your doctor who might have to put you in contact with a mental health clinician that is experienced in treating PTSD. Be honest and open and remember that you are entitled to a second opinion.
Tests that may be used in diagnosis of PTSD include:
- Physical examination, blood tests and screening: This is done to determine that the symptoms you have are not due to another underlying medical condition. The doctor will also look for any signs of other physical health problems that people with PTSD are more likely than others to develop, such as heart disease, diabetes and pain syndromes.
- Psychiatric exam: A psychiatrist or psychologist will talk with you about your thoughts, feelings and mood. They may use a questionnaire to help them. They will also determine whether you have any other mental health condition.
- DSM-5: Your doctor or mental health professional may use the criteria for PTSD listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association (these are the symptoms listed earlier).
What causes PTSD?
PTSD is a medical condition that can potentially affect people of all ages and from any social and economic background.
Due to the high rates of violent crimes (physical and sexual assault, hi-jacking, domestic violence, etc) in South Africa, a diagnosis of PTSD is relatively common amongst the population. In data obtained from youth and patients attending clinics, rates of PTSD as high as 20 % have been reported.
Importantly, not everyone who is exposed to trauma will develop PTSD, but women are almost twice as likely as men to develop PTSD.
Other risk factors for developing PTSD can include:
- Genetics/having a family history of mental health illness, especially in a parent or sibling.
- Experiencing trauma that was intense or of long duration.
- Having experienced other trauma early in life, such as childhood abuse.
- Having a job that increases your risk of being exposed to traumatic events, particularly as related to physical combat.
- Having other mental health problems, like anxiety or depression.
- Abusing substances like alcohol or recreational drugs.
- Lacking a support system.
Living and managing
Coping with PTSD can be challenging. Here are some ways that can help you cope with your condition:
- If you or a loved one has experienced trauma, educate yourself on common reactions to trauma and PTSD: There is some preliminary evidence to suggest that starting with PTSD treatment (medications and/or psychotherapy) within a short period of time after a traumatic event may prevent the onset of PTSD, but further work in this area is still needed.
- Do not isolate yourself but take time to converse with others, especially those who are likely to offer you help and support: Recognise that avoidance and withdrawal are part of the disorder. If your loved one is resisting help, allow them space and let them know that you are available when they are ready to accept your help.
- Do things that you enjoy and that help you to relax: When you start feeling anxious, break the cycle by engaging in hobbies to redirect your mind or by doing activities that help you to relax, such as listening to music or going for walks.
- Try to maintain a healthy lifestyle: It is important that you exercise regularly, eat a healthy diet and get adequate sleep to help manage your mental health condition successfully.
- Find a support group for people with PTSD: Get more resources to help you cope and to reduce any negative feelings or stigma you may feel about having PTSD. A support group can also help empower and motivate you to stick to your treatment plan.
Find out more about PTSD on Let’s Talk. You can find resources that you may find useful in helping to manage stress and stay positive. You can also find out about where to get help if you are struggling to cope and need someone to talk to.
What treatment is available for PTSD?
Antidepressants are commonly prescribed for PTSD. Medication is most effective in combination with psychotherapy. Medication will act to relieve symptoms of PTSD, thus making the person more susceptible to techniques used in psychotherapy. Anti-anxiety medications may also be of benefit.
Cognitive behavioural therapy (CBT) is widely used as a form of psychotherapy for persons with PTSD and has shown to be effective in helping persons with PTSD return to normal functioning. The therapeutic environment (whether group or individual treatment) provides a safe place for persons with PTSD to discuss traumatic events, and express the fears and reactions associated with it.
Most persons who seek treatment ultimately enjoy a better quality of life. However, it is important to remember that treatment response varies and what may work for one person may not necessarily work for the next.
How might PTSD affect daily functioning?
For someone with PTSD, mentally re-living an event can be as traumatic as the actual event. Physical and psychological symptoms that go hand in hand with such experiences are worsened by feelings of embarrassment, confusion and frustration.
Despite being a disorder characterised by very specific symptoms, PTSD can be misdiagnosed. Living with untreated PTSD can place significant strain on relationships, as persons with PTSD will withdraw from normal social and interpersonal activities. PTSD often co-occurs with mental health conditions like depression, substance abuse or another anxiety disorder.
Sources
Let’s Talk. (n.d.) Conditions: Post Traumatic Stress Disorder. Available from: http://letstalkmh.co.za/condition/post-traumatic-stress-disorder/
Mayo Clinic staff. (n.d.) Diseases and Conditions: Post-traumatic stress disorder (PTSD). Mayo Clinic. Available from: https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967
Mayo Clinic staff. (n.d.) Diagnosis and Treatment: Post-traumatic stress disorder (PTSD). Mayo Clinic. Available from: https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/diagnosis-treatment/drc-20355973
Tull M. (2020) How PTSD Relates to Physical Health Issues. Verywell Mind. Available from: https://www.verywellmind.com/ptsd-and-physical-health-2797522
Sources
Let’s Talk. (n.d.) Conditions: Post Traumatic Stress Disorder. Available from: http://letstalkmh.co.za/condition/post-traumatic-stress-disorder/
Mayo Clinic staff. (n.d.) Diseases and Conditions: Post-traumatic stress disorder (PTSD). Mayo Clinic. Available from: https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967
Mayo Clinic staff. (n.d.) Diagnosis and Treatment: Post-traumatic stress disorder (PTSD). Mayo Clinic. Available from: https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/diagnosis-treatment/drc-20355973
Tull M. (2020) How PTSD Relates to Physical Health Issues. Verywell Mind. Available from: https://www.verywellmind.com/ptsd-and-physical-health-2797522